My daughter, diagnosed with diabetes when she was 12 years old and on an insulin pump for two years, is an athlete who is a sophomore in college on the basketball and track team. What should she eat and drink before practice or a game as well as before bedtime to prevent her from experiencing a low because of the level of exercise involved? After games last year, the team was given a lot of pizzas and subs to eat. Should she be eating something different because of her diabetes? We want to be sure she is consuming the right kinds of foods this year.

Basketball involves a lot of stop and go movements and quick, powerful moves with the examples of shooting, passing and dribbling. It is much more anaerobic in nature than aerobic. Duration of basketball practices and games and circulating insulin levels during play are what affect blood glucose levels the most.

General rules of thumb for basketball:

An individual with diabetes on an insulin pump may need an additional 10-30 grams of carbohydrate per hour, depending on circulating insulin levels and initial blood glucose levels before practice or a game situation.
Reduce carbohydrate intake for exercise with lower circulating insulin levels ( e.g., when the pump is removed three to four hours after the last bolus of insulin.
Eat a bedtime snack following prolonged activity to reduce the risk of nocturnal hypoglycemia. Usually this is in the form of some type of protein.

You mentioned track however you did not specify what particular events your daughter engages in. Most track and field events are short, requiring near maximal muscular contraction (example; shot put)or near maximal full body effort (example; sprinting).These types of event are anaerobic in nature. Longer track event (e.g. 800-meter runs) require more energy production from the lactic acid system but are still anaerobic in natue. Longer distance running events including interval training are more aerobic in nature. Changes in insulin dosages and/or diet are really determined by the duration of aerobic activities and are usually less affected by anaerobic activities. Blood glucose levels may tend to decrease more after track practices/meets when muscle glycogen is restored than during track practices/meets.

General rules of thumb for track:

Make minimal increases in carbohydrate intake for short intense activities.
Increase carbohydrate intake by 10-15 grams per hour for practices that are extended depending on reduction of insulin.
Bedtime snack — Once again, consume a snack in the form of a protein to prevent nocturnal hypoglycemia.

Remember: Always check blood glucose before, during and after practices or meets to determine what the needs are.

PL